tv Newsmakers CSPAN January 16, 2011 6:00pm-6:30pm EST
a lot of very careful work with state insurance commissioners across the country with a lot of insurance providers and i'm pleased to say every deadline has been met and people are beginning to connect with the benefits they have available to them and that is very good news. in terms of overall costs, we said from the outset that a lot
of the assets here at the department of health and human services were already folks with expertise in some of these areas. we hired some new people in the private insurance areas where we did not have individuals familiar with that, so former state insurance commissioners and former consumer advocates are now helping to develop programs in that area, but so far we have done a good job at not only getting the regulations out on time, and forming people with this wonderful new website which, for the first time ever in history gives individuals a way to go on the website, type in a zip code and call-up every public program, every private program available to them and their age group and in their neighborhood, and figure out ways they may be able to access
affordable health care or do some shopping. all of those things are happening on time and on budget. >> madam secretary, as the house prepares to vote this week to rescind the entire new health- care law, republicans have more than enough votes to pass their bill. another common wisdom is this will largely be a symbolic vote because democrats control the senate and white house. even if it is largely symbolic, are there cautionary messages to the obama administration in this upcoming vote? >> i think it gives us an opportunity since the house is chosen to do this as their first order of business rather than work on jobs and the economy, which the american public has said is clearly their number one priority, it does present an opportunity for us to remind people what the new house leadership and house member
majority is voting to take away. the kind of freedom that americans are just beginning to realize, where they can loosen the chokehold of insurance companies and began to make more choices and connections. seniors would lose the annual wellness check up that just begins in 2011. they would not have an opportunity to forgo copays for preventive care. young adults would never be able to keep their children on the family plan which lots of families have taken advantage of. small-business owners would have to give up their ability to keep their employees in the health insurance market because of the tax credits offered. we can have a conversation reminding people what is at stake and go back to the days where insurance companies controlled who had access to cover -- who had access to coverage and you didn't and
could put a lifetime cap on sick person's benefits so that they run out of money when the treatment they need was under way. there is a lot at stake. it may be symbolic, but it is very real for lots of americans. >> clearly you are using this vote as a forum to remind people of what are the affirmative aspects of passing this law. are there no danger signs politically or substantively? >> there is always a cautionary note with a new piece of legislation. when social security was passed, there were numerous votes to repeal the legislation over and over again until the full benefits kick in five years after the passage of the bill. once people understood what social security meant to their future and the stability, it became wildly popular.
we have a job to reach out to people and educate them. i thought one of the most interesting pieces of data recently was the congressional budget office suggesting a vote to repeal this bill would add $230 billion to the deficit in the first decade. closer to a trillion dollars in the next decade. we have members of congress who suggested there number one priority was getting americans back to work and dealing with the growing deficit in this country and are going to take a vote that obviously does not put anybody back to work and may jeopardize the work force and adds hugely to the deficit already looming for our grandchildren. >> jeffrey young from the bloomberg news is with us. >> returning to the subject of
the implementation of this law, it is a very large task with a lot of things to be carried out. your department responsibilities have grown since president obama has taken office. the food safety law president obama signed, new regulatory authority over tobacco products. with the president's budget to in the near future, do you anticipate you are going to be needing asking for the funding for the department asking to write the laws for regulations in an atmosphere where pub -- where republicans are talking about slashing budgets over all and attending to defund legislation for the health-care law. do you expect to get and if not, could you cope with less? >> i understand the budget discussions which began months ago between the office of
management and budget and individual departments across the government have been difficult because from the outset, the president made it clear we need to restrict our spending and look carefully at what our priorities are. we've asked our agencies which have had decreases from where we were last year and looked at ways we can stop funding activities that have little value now and into the future. you are absolutely right. we have a number of new and important assignments, but we have some very creative leaders who have scrubbed their agency budgets to see where it is their cost savings, what kind of programs may have made sense 10 or 15 years ago that don't make sense now. how can we use existing resources to move forward?
my experience as governor, serving during tough times, balancing by law because states have a constitutional mandate that we had to present a balanced budget, give me experience in looking at what resources we have and figuring out ways to move forward. these are challenging times and we're certainly willing to do our fair share. we do not want to jeopardize the real priorities in this department, some of which are high priorities, funding important science and research that goes on at the national institutes of health. implementation of the health reform bill, some of our really critical family and children's programs in this difficult economic time are really providing and helping support
families so they can continue to work and no their kids are in a safe place. we are juggling those priorities and have every intent to continue to fulfill the mission of delivering health services and providing essential human services. >> you do not have any concern that the burdens that are placed on your department and the agencies under a might be too great with less funding -- in other words, doing more with less, is an achievable goal? >> would we like to have additional resources? you bet. i don't think has been a realistic view going forward. what we are looking at is -- this is not brand new, this has been underway for months. how do we maximize the resources we have, how do we make sure we can fill this very important
assignment or the american people and do it with the assets at hand. congress in the lame duck session only passed a continuing resolution that goes until march. we do not know what the next step looks like, if it will halfway through the fiscal year reduce what we have to spend overall, so we have been very cautious with our leadership saying cannot hire large soap -- to not hire a lot of new people or start new programs. we may have fewer assets in three months than we have right now and we need to be very cautious about additional spending but also very aggressive about filling the mission the president has given us. >> our guest is kathleen
sebelius, health and human services secretary. we're discussing repealing the health bill signed into legislation last year. there is a new poll al that says 75% of the american public wants the health care law changed. 38%, down from 52% say they want to repeal it. would the administration be able to look at changes to the health care law as proposed by the house and passed by the senate? >> we have said from the outset that there were a number of good ideas that could not be included in the bill because of the procedure on the senate side that had some very strict budget rules, the reconciliation procedure. we know that there are things that need -- the 1099 reporting
which could be a burden to small business and performance has been proposed. we are eager to work here with congress to change that feature. can that bill be improved? i think about medicare when my dad was in congress. he served on the congress committee and helped to write the medicare law. medicare today looks very little like it did when he served. he will be 90 in march and it has changed and improved and changed with medical times and this is a platform for a new health-care system, for access for people who have never had access to affordable coverage and for the new rules for
insurance companies. as we go forward, we look forward to working with and discussing with congress ways that can be improved. >> it sounds as if the new republican leaders are getting to test the administration's receptivity to change. they have said over this repeal vote that they intend to pick apart piece by piece parts of the new law that they dislike. one part of a particularly demonize and the polls show the public is not crazy about is the so-called individual mandate which would require most americans to carry health insurance. this is not something the president was initially in favor of. what are your views as to whether the law could function well if the mandate were taken out? >> there are responsibility pieces built into the law. there is an employer responsibility section which indicates if you are a larger
employer in this country, if you hire more than 50 individuals, you should contribute to those employees health-care. if not, you should contribute to a fund because your employees may be getting taxpayer-provided health care. there is a provision about the federal government that anticipates public programs will continue to cover seniors and make sure they are guaranteed benefits and their guarantees are safe and secure and we are solvent going forward, that we will cover the lowest income americans and disabled americans with the medicaid program. for those individuals who either do not have employer-based coverage for do not fall into the federal program qualifiers, there is a personal responsibility peace. with that responsibility comes financial assistance that people
will be able to pick and choose from the programs that members of congress will have available to them and have financial assistance in order to do it. there is a waiver provision saying if you can afford health insurance, you will be waived out of the program. having everybody in the pool is a way to make sure we balance benefits for those who are sick and need the benefits right now and those who may get sick in the future. it is a way to have a stable, solvents insurance pool and that is why the individual responsibility peace is an important leg of this tool. >> you have articulated the case for the mandate. i wonder if there are circumstances under which you may be able to relinquish it? >> there are lots of challenging the constitutionality of the law, but most focuses on the mandate.
at the case for a solvent insurance pool makes good sense. it is about trying to get everybody covered. for families to have insurance, they pay about $1,000 more on their premium every year for the folks on their communities coming through emergency room doors without insurance coverage. those costs are not disappearing. everyone can access the health- care system whether or not they have insurance. it's just more expensive and less affected than being borne by employers and individuals. the structures passed by the congress and signed into law by the president is the best way to not only have everyone in the pool, but provide everyone with a kind of freedom from the restrictions that insurance companies have always had over people with pre-existing
conditions. it is very difficult to get rid of the rules that say you cannot be ensured if your child has cancer or at asthma. you cannot come into the program if you have had a heart attack. if you only have people who buy insurance after they have an illness, you would very quickly bankrupt insurance companies and a banker of the plan. everyone participates for getting rid of the onerous rules that insurance companies have that have locked people with pre-existing conditions out of the market. that seems to be the appropriate balance to strike. >> beyond the expense reporting provision you mentioned as something you think should be fixed, the president has indicated he feels the same way. have you identified other
elements of the law which you think will require new legislation to make them work better? if you have, could you share some examples? do you think the republican majority in the house is more interested in repeal law that helping to make it work better? can you get that accomplished or if not, what structure does that put you under? >> i think there are conversations underway, as you know, a lot of the law is just being realized as we speak. it was signed into being nine months ago, so we have not had enough experience with some of the features to know whether or not the legal structure is really sound or whether we have the administrative flexibility to address what may be some problems. whether it is a doctor groups or
employer groups and realizing that, we can have a regulation that actually meets the needs of people to have some flexibility between now and 2014 when we have some in the markets. 1099 stands out as a feature that does need to be fixed. but you are absolutely right. there are folks in the congress right now that want to see the bill failed. if they are not successful for a vote to repeal, they will resist any vote to approve. i am hoping that a majority of legislatures -- majority of legislators don't feel that way and will listen to their constituents. going back to the dramatic increase year in and year out, the underlying cost, the
skyrocketing premiums bankrupting families and business owners. having insurance companies make the rules instead of giving the freedom to consumers and seniors is a dangerous step back. we will be working with congress, suggesting changes and i hope they are less -- i hope they are interested in improvements and not interested in just having this very important law fail. >> speaking of resistance from republicans in congress to the health law, you met a few days ago with congressman dave camp who will be chairing the ways and means committee. he and other senior republican committee members in the house say they intend to bring you down to the hill for hearing after hearing after hearing. there will be investigations and
subpoenas. the agencies that have to work under you will probably have similar things placed on them. how cooperative can you be? will you be responsive to the subpoenas or attend the hearings when invited or when more than invited? >> as i told the chairman, who i worked with since i have been in washington and we have a closer personal connection and a family house in northern michigan in his district, so i am one of his constituents, but i made the visit to the chairman's office to offer to help in any way that we can. i will be responsive to congressional requests to testify about the budget and
issues in our department. we will make every effort to have the witnesses he wants there when he wants them to work with their staffing. having an oversight role for congress is very important and its information they need to gather to inform themselves and answer questions for constituents. i was there to suggest we look forward to that and we want an open and honest dialogue and give them information in a timely fashion and we fully intend to do that. i am hopeful that what will happen is a good dialogue and that -- there are a lot of new members of congress to do not know a lot about the programs in our agencies, much less than other governments. there will be a learning curve and an opportunity to share
information about the range of programs and the impact we have on individual families and business owners far beyond health reform, whether it is the great universities or they'd mental health services we help fund in their neighborhoods and backyards. i look forward to those discussions. >> the judicial branch of government is also active in looking at the health care law. what is your strategy if the court cases overturns the health care law? >> again, what we have so far as you know is that three federal judges have ruled on cases, two of the judges, one in michigan and one in virginia have found a lot to be constitutional.
a second judge in virginia has ruled the portion of the law dealing with the individual responsibility is unconstitutional. but in that case, a judge was asked to stay the implementation and stop us from implementing the law. he has at this point given us the opportunity to continue to move forward. this is the law as the case works its way through the system. a judge who has not ruled as in florida where there is a consolidated case. my guess is we will have continued opinions by courts and continue to move forward. they are handling the legal debate, but what i find is talking to the new governor's being sworn in, certainly
working with insurance commissioners and others that while there may be ongoing legal discussions in the court, there is a lot of implementation work going on at the state's with people who have access the planning grants and are putting together the framework for an exchange at a new marketplace. states anxious to tap into the website. states around the country who have taken advantage of the new consumer grants so that people have folks on the ground they can go to for help when they're shopping for insurance coverage and lots of work going on looking at the changing marketplace getting ready for the future. the court cases will continue to wend their way along. in the meantime, it is full steam ahead. >> there have been three
district court rulings so far. two dozen federal court cases and it is a safe bet that no matter which way the remaining judges will, there will be appeals. it is going to take awhile for this to get appealed in the judicial system. if your department making any contingency plans or are you just hoping for the best? >> i don't know what those contingency plans would be. our job is this is the law and we are working to educate americans about the benefits they can take advantage of about the new freedoms they have in terms of parents keeping their kids on their plans and seniors to have a wellness visit as part of the plan and closing down of a whole. 50% of the down at all plants will disappear things to be affordable care act, setting up
the training program for new doctors and nurses, so we will continue to implement the law as long as it is the law and i hope that is for centuries to come. >> kathleen sebelius is the secretary of health and human services. thank you for being with us. you talked about the republican plan to put health and human services and other health-care officials under the gun when it comes to hearings. what is the strategy there and how important will that be? >> the chairman and the new leaders of the house as of last week for the week before, the way they have described it is they believe the law is bad and it is not going to work and could actually do harm to health care companies, etc.. they say that they view the
opportunity to hold these hearings and have people from the administration of there as a way to show the american people what the problems are going to be or possibly already are. it has been described to me by republicans on the hill as the first step toward 2013 when they hope they will have won the white house and have control of this and at and can repeal the entire bill. they're building a case toward that is what they're talking about. >> he started off talking about cautionary notes for the administration in a symbolic vote in the house. why did you start that? >> is secretary made clear that their strategy is to use this new opposition that is in one half of congress as a forum to make a positive case. i wanted to hear whether she would knowledge whether there's any down side to that opposition. she did not ack